Impaired mobility and Parkinson’s disease

By A. Ashburn and Emma Stack

Abstract

Impaired mobility associated with frequent falls is common in Parkinson's disease (PD) and is the focus of three related papers in this issue. Walking quietly forward, in a straight line across a smooth surface presents people with PD with a basic challenge but when the mobility task is in any way more complex, the level of challenge rises steeply for people with PD.<br/><br/>Ashburn et al.'s diary-based survey of over 600 falls suggests that only a handful of activities account for the majority of falls among people with PD, with ‘tripping while walking’ taking first place and ‘falling while turning’ being associated with serious injury. Jones et al.'s qualitative study explores how the distressing uncertainty that one can walk safely from A to B without falling is detrimental to self-esteem and participation in society. In this paper, like that of Ashburn et al., the authors discuss how any kind of ‘multi-tasking’ exacerbates the risk of falling. Stack et al.'s paper describes an analysis of turning to walk from a standing start, an activity that most healthy adults accomplish readily, and discusses why people with PD find turning so notoriously challenging. All three papers address methodological issues around the assessment of mobility, falls and fallers and the authors make innovative suggestions about rehabilitation practice. Together, this survey, interview set and movement analysis add to the existing knowledge base on falls and illuminate difficulties specific to PD. The combination of research methods is successfully drawing researchers to what patients consider the key issues, optimizing the immediate relevance of the research output<br/><br/><br/